気管支動脈-肺動脈瘻を有する気管支動脈蔓状血管腫

Racemose Hemangioma of the Bronchial Artery with Pulmonary Artery Fistula

気管支動脈蔓状血管腫は気管支動脈が蔓状に屈曲・蛇行・拡張し，時に大量喀血の原因となる疾患である．われわれは，無症状で発見され，気管支動脈塞栓術（bronchial artery embolization：BAE）後に気管支動脈切除術を施行した気管支動脈-肺動脈瘻を有する気管支動脈蔓状血管腫の1例を経験したので，若干の文献的考察を加えて報告する．

A 55-year-old woman was suspected of having hilar lymph node enlargement on a routine examination of the chest computed tomography （CT） scan at our hospital. On further examination, thoracic contrast CT and bronchial arteriography showed prominent dilation and meandering of the right bronchial artery with an aneurysm which formed a fistula to the pulmonary artery A7 at its distal end. Diagnosed as racemose hemangioma of bronchial artery with pulmonary artery fistula, we performed a surgical resection by open thoracotomy on the second day following bronchial artery embolization （BAE）. No recurrence was observed in the five years of follow-up period after surgery. Therefore, surgical resection for asymptomatic racemose hemangioma of bronchial artery with bronchial artery-pulmonary artery fistula can be considered an effective method for the long-term prevention of bleeding.